2026 Blue Rx PDP Complete (PDP) formulary (drug list)

Contract S5593, plan 003 · West Virginia · 3,788 drugs on file · formulary ID 00026017. Each drug links to its cost in every CMS PDP Region 06 plan.

165 drugs starting with N.

Drug name	Tier	30-day preferred pharmacy	90-day mail order	Usage management
NABUMETONE 500 mg Tablet, Film Coated	1Preferred Generic	$0.00	$0.00	None
NABUMETONE 750 mg Tablet	1Preferred Generic	$0.00	$0.00	None
NADOLOL 20 mg Tablet	1Preferred Generic	$0.00	$0.00	None
NADOLOL 40 mg Tablet	1Preferred Generic	$0.00	$0.00	None
NADOLOL 80 mg Tablet	1Preferred Generic	$0.00	$0.00	None
NAFCILLIN 1 g/4mL Injection, Powder, For SolutionNafcillin Sodium	2Generic	$5.00	$12.50	None
NAFCILLIN 10 g Injection, Powder, For Solution	5Specialty Tier	25%	N/A	None
NAFCILLIN 2 g/8mL Injection, Powder, Lyophilized, For SolutionNafcillin Sodium	4Non-Preferred Drug	25%	25%	None
NAFTIFINE HYDROCHLORIDE 10 mg/g Cream	4Non-Preferred Drug	25%	25%	ST QL 9 per 28 days
NAFTIFINE HYDROCHLORIDE 20 mg/g Cream	4Non-Preferred Drug	25%	25%	ST QL 6 per 28 days
NAFTIFINE HYDROCHLORIDE 20 mg/g Gel	4Non-Preferred Drug	25%	25%	ST QL 6 per 28 days
NALOXONE HYDROCHLORIDE .4 mg/mL Injection, Solution	2Generic	$5.00	$12.50	None
NALOXONE HYDROCHLORIDE .4 mg/mL Injection, Solution	2Generic	$5.00	$12.50	None
NALOXONE HYDROCHLORIDE .4 mg/mL Injection, Solution	2Generic	$5.00	$12.50	None
NALOXONE HYDROCHLORIDE 1 mg/mL Injection	2Generic	$5.00	$12.50	None
NALTREXONE HYDROCHLORIDE 50 mg Tablet, Film Coated	2Generic	$5.00	$12.50	None
NAPROXEN 250 mg Tablet	1Preferred Generic	$0.00	$0.00	None
NAPROXEN 375 mg Tablet	1Preferred Generic	$0.00	$0.00	None
NAPROXEN 375 mg Tablet, Delayed Release	2Generic	$5.00	$12.50	None
NAPROXEN 500 mg Tablet	1Preferred Generic	$0.00	$0.00	None
NAPROXEN 500 mg Tablet, Delayed Release	2Generic	$5.00	$12.50	None
NAPROXEN SODIUM 275 mg Tablet, Film Coated	1Preferred Generic	$0.00	$0.00	None
NAPROXEN SODIUM 550 mg Tablet	1Preferred Generic	$0.00	$0.00	None
NAPROXEN SODIUM 750 mg Tablet, Film Coated, Extended Release	4Non-Preferred Drug	25%	25%	None
NARATRIPTAN 1 mg Tablet	2Generic	$5.00	$12.50	QL 2 per 28 days
NARATRIPTAN 2.5 mg Tablet	2Generic	$5.00	$12.50	QL 9 per 28 days
NATEGLINIDE 120 mg Tablet, Film Coated	1Preferred Generic	$0.00	$0.00	QL 93 per 31 days
NATEGLINIDE 60 mg Tablet, Film Coated	1Preferred Generic	$0.00	$0.00	QL 93 per 31 days
NAYZILAM 5 mg/.1mL SprayMidazolam	4Non-Preferred Drug	25%	25%	PA QL 1 per 30 days
NEBIVOLOL 10 mg Tablet	2Generic	$5.00	$12.50	QL 93 per 31 days
NEBIVOLOL 2.5 mg Tablet	2Generic	$5.00	$12.50	QL 93 per 31 days
NEBIVOLOL 20 mg Tablet	2Generic	$5.00	$12.50	QL 62 per 31 days
NEBIVOLOL 5 mg Tablet	2Generic	$5.00	$12.50	QL 217 per 31 days
NECON KitNorethindrone And Ethinyl Estradiol	2Generic	$5.00	$12.50	None
NEFAZODONE HYDROCHLORIDE 100 mg Tablet	2Generic	$5.00	$12.50	None
NEFAZODONE HYDROCHLORIDE 150 mg Tablet	2Generic	$5.00	$12.50	None
NEFAZODONE HYDROCHLORIDE 200 mg Tablet	2Generic	$5.00	$12.50	None
NEFAZODONE HYDROCHLORIDE 250 mg Tablet	2Generic	$5.00	$12.50	None
NEFAZODONE HYDROCHLORIDE 50 mg Tablet	2Generic	$5.00	$12.50	None
NEMLUVIO 30 mg/100mg Injection, Powder, Lyophilized, For SolutionNemolizumab-Ilto	5Specialty Tier	25%	N/A	PA QL 2 per 28 days
NEO-SYNALAR 3.5/.25 mg/g CreamNeomycin Sulfate And Fluocinolone Acetonide	4Non-Preferred Drug	25%	25%	None
NEOMYCIN AND POLYMYXIN B SULFATES AND BACITRACIN ZINC 3.5/10000/400 mg/g/[USP'U]/g OintmentNeomycin Sulfate, Polymyxin B Sulfate And Bacitracin Zinc	2Generic	$5.00	$12.50	None
NEOMYCIN AND POLYMYXIN B SULFATES AND DEXAMETHASONE 3.5/10000/1 mg/g/[USP'U]/g OintmentNeomycin Sulfate, Polymyxin B Sulfate, And Dexamethasone	2Generic	$5.00	$12.50	None
NEOMYCIN AND POLYMYXIN B SULFATES AND GRAMICIDIN 1.75/10000/.025 mg/mL/[USP'U]/mL Solution/ DropsNeomycin Sulfate, Polymyxin B Sulfate And Gramicidin	2Generic	$5.00	$12.50	None
NEOMYCIN AND POLYMYXIN B SULFATES AND HYDROCORTISONE 10/3.5/10000 mg/mL/[USP'U]/mL Suspension/ DropsNeomycin Sulfate, Polymyxin B Sulfate And Hydrocortisone	2Generic	$5.00	$12.50	None
NEOMYCIN AND POLYMYXIN B SULFATES AND HYDROCORTISONE 3.5/10000/10 mg/mL/[USP'U]/mL Solution/ DropsNeomycin Sulfate, Polymyxin B Sulfate, Hydrocortisone	2Generic	$5.00	$12.50	None
NEOMYCIN AND POLYMYXIN B SULFATES AND HYDROCORTISONE 3.5/10000/10 mg/mL/[USP'U]/mL SuspensionNeomycin Sulfate, Polymyxin B Sulfate And Hydrocortisone	2Generic	$5.00	$12.50	None
NEOMYCIN AND POLYMYXIN B SULFATES, BACITRACIN ZINC AND HYDROCORTISONE 3.5/10000/400/10 mg/g/[USP'U]/g OintmentNeomycin Sulfate And Polymyxin B Sulfate, Bacitracin Zinc And Hydrocortisone	2Generic	$5.00	$12.50	None
NEOMYCIN POLYMYXIN B SULFATES AND DEXAMETHASONE 3.5/10000/1 mg/mL/[USP'U]/mL Suspension/ DropsNeomycin Sulfate, Polymyxin B Sulfate And Dexamethasone	2Generic	$5.00	$12.50	None
NEOMYCIN SULFATE 500 mg Tablet	2Generic	$5.00	$12.50	None
NERLYNX 40 mg TabletNeratinib	5Specialty Tier	25%	N/A	PA QL 186 per 31 days
NEUAC 10/50 mg/g GelClindamycin Phosphate And Benzoyl Peroxide	2Generic	$5.00	$12.50	None
NEUPRO 1 mg/24h Patch, Extended ReleaseRotigotine	4Non-Preferred Drug	25%	25%	None
NEUPRO 2 mg/24h Patch, Extended ReleaseRotigotine	4Non-Preferred Drug	25%	25%	None
NEUPRO 3 mg/24h Patch, Extended ReleaseRotigotine	4Non-Preferred Drug	25%	25%	None
NEUPRO 4 mg/24h Patch, Extended ReleaseRotigotine	4Non-Preferred Drug	25%	25%	None
NEUPRO 6 mg/24h Patch, Extended ReleaseRotigotine	4Non-Preferred Drug	25%	25%	None
NEUPRO 8 mg/24h Patch, Extended ReleaseRotigotine	4Non-Preferred Drug	25%	25%	None
NEVIRAPINE 200 mg Tablet	2Generic	$5.00	$12.50	None
NEVIRAPINE 400 mg Tablet, Extended Release	4Non-Preferred Drug	25%	25%	None
NEVIRAPINE 50 mg/5mL Suspension	2Generic	$5.00	$12.50	None
NEXLETOL 180 mg Tablet, Film CoatedBempedoic Acid	4Non-Preferred Drug	25%	25%	PA QL 31 per 31 days
NEXLIZET 180/10 mg Tablet, Film CoatedBempedoic Acid And Ezetimibe	4Non-Preferred Drug	25%	25%	PA QL 31 per 31 days
NEXPLANON 68 mg ImplantEtonogestrel	3Preferred Brand	25%	25%	None
NIACIN 1000 mg Tablet, Extended Release	3Preferred Brand	25%	25%	None
NIACIN 500 mg Tablet, Extended Release	3Preferred Brand	25%	25%	QL 31 per 31 days
NIACIN 750 mg Tablet, Film Coated, Extended Release	3Preferred Brand	25%	25%	None
NICARDIPINE HYDROCHLORIDE 20 mg Capsule	2Generic	$5.00	$12.50	None
NICARDIPINE HYDROCHLORIDE 30 mg Capsule	4Non-Preferred Drug	25%	25%	None
NICOTROL 10 mg/mL Spray, MeteredNicotine	4Non-Preferred Drug	25%	25%	None
NIFEDIPINE 30 mg Tablet, Extended Release	2Generic	$5.00	$12.50	None
NIFEDIPINE 30 mg Tablet, Film Coated, Extended Release	2Generic	$5.00	$12.50	None
NIFEDIPINE 60 mg Tablet, Extended Release	2Generic	$5.00	$12.50	None
NIFEDIPINE 60 mg Tablet, Film Coated, Extended Release	2Generic	$5.00	$12.50	None
NIFEDIPINE 90 mg Tablet, Extended Release	2Generic	$5.00	$12.50	None
NIFEDIPINE 90 mg Tablet, Film Coated, Extended Release	2Generic	$5.00	$12.50	None
NILOTINIB 150 mg Capsule	5Specialty Tier	25%	N/A	PA QL 124 per 31 days
NILOTINIB 200 mg Capsule	5Specialty Tier	25%	N/A	PA QL 124 per 31 days
NILOTINIB 50 mg Capsule	5Specialty Tier	25%	N/A	PA QL 124 per 31 days
NILUTAMIDE 150 mg Tablet	5Specialty Tier	25%	N/A	None
NIMODIPINE 30 mg Capsule, Liquid Filled	2Generic	$5.00	$12.50	None
NINLARO 2.3 mg CapsuleIxazomib	5Specialty Tier	25%	N/A	PA QL 3 per 28 days
NINLARO 3 mg CapsuleIxazomib	5Specialty Tier	25%	N/A	PA QL 3 per 28 days
NINLARO 4 mg CapsuleIxazomib	5Specialty Tier	25%	N/A	PA QL 3 per 28 days
NISOLDIPINE 17 mg Tablet, Film Coated, Extended Release	2Generic	$5.00	$12.50	None
NISOLDIPINE 34 mg Tablet, Film Coated, Extended Release	2Generic	$5.00	$12.50	None
NISOLDIPINE 8.5 mg Tablet, Film Coated, Extended Release	2Generic	$5.00	$12.50	None
NITAZOXANIDE 500 mg Tablet, Film Coated	5Specialty Tier	25%	N/A	None
NITISINONE 10 mg Capsule	5Specialty Tier	25%	N/A	PA
NITISINONE 2 mg Capsule	5Specialty Tier	25%	N/A	PA
NITISINONE 20 mg Capsule	5Specialty Tier	25%	N/A	PA
NITISINONE 5 mg Capsule	5Specialty Tier	25%	N/A	PA
NITRO-BID 20 mg/g OintmentNitroglycerin	2Generic	$5.00	$12.50	None
NITROFURANTOIN (MACROCRYSTALS) 100 mg Capsule	2Generic	$5.00	$12.50	QL 9 per 365 days
NITROFURANTOIN (MONOHYDRATE/MACROCRYSTALS) 75/25 mg Capsule	2Generic	$5.00	$12.50	QL 9 per 365 days
NITROFURANTOIN MACROCRYSTALS 25 mg Capsule	2Generic	$5.00	$12.50	QL 36 per 365 days
NITROFURANTOIN MACROCRYSTALS 50 mg Capsule	2Generic	$5.00	$12.50	QL 18 per 365 days
NITROGLYCERIN .1 mg/h Patch	2Generic	$5.00	$12.50	None
NITROGLYCERIN .2 mg/h Patch	2Generic	$5.00	$12.50	None
NITROGLYCERIN .3 mg Tablet	2Generic	$5.00	$12.50	None
NITROGLYCERIN .4 mg Tablet	2Generic	$5.00	$12.50	None
NITROGLYCERIN .4 mg/h Patch	2Generic	$5.00	$12.50	None
NITROGLYCERIN .6 mg Tablet	2Generic	$5.00	$12.50	None
NITROGLYCERIN .6 mg/h Patch	2Generic	$5.00	$12.50	None
NITROGLYCERIN 4 mg/g Ointment	4Non-Preferred Drug	25%	25%	None
NITROGLYCERIN LINGUAL 400 ug SprayNitroglycerin	3Preferred Brand	25%	25%	None
NIVESTYM 300 ug/.5mL Injection, SolutionFilgrastim-Aafi	5Specialty Tier	25%	N/A	None
NIVESTYM 300 ug/mL Injection, SolutionFilgrastim-Aafi	5Specialty Tier	25%	N/A	None
NIVESTYM 480 ug/.8mL Injection, SolutionFilgrastim-Aafi	5Specialty Tier	25%	N/A	None
NIVESTYM 480 ug/1.6mL Injection, SolutionFilgrastim-Aafi	5Specialty Tier	25%	N/A	None
NIZATIDINE 150 mg Capsule	2Generic	$5.00	$12.50	None
NIZATIDINE 300 mg Capsule	2Generic	$5.00	$12.50	None
NORDITROPIN 10 mg/1.5mL Injection, SolutionSomatropin	5Specialty Tier	25%	N/A	PA
NORDITROPIN 15 mg/1.5mL Injection, SolutionSomatropin	5Specialty Tier	25%	N/A	PA
NORDITROPIN 5 mg/1.5mL Injection, SolutionSomatropin	5Specialty Tier	25%	N/A	PA
NORETHINDRONE .35 mg Tablet	2Generic	$5.00	$12.50	None
NORETHINDRONE ACETATE 5 mg Tablet	2Generic	$5.00	$12.50	None
NORETHINDRONE ACETATE AND ETHINYL ESTRADIOL 1/.02 mg Tablet	2Generic	$5.00	$12.50	None
NORETHINDRONE ACETATE AND ETHINYL ESTRADIOL 1/5 mg/ug Tablet	2Generic	$5.00	$12.50	None
NORGESTIMATE AND ETHINYL ESTRADIOL Kit	2Generic	$5.00	$12.50	None
NORGESTIMATE AND ETHINYL ESTRADIOL Kit	2Generic	$5.00	$12.50	None
NORTREL 21 DAY 1/.035 mg TabletNorethindrone And Ethinyl Estradiol	2Generic	$5.00	$12.50	None
NORTREL 28 DAY KitNorethindrone And Ethinyl Estradiol	2Generic	$5.00	$12.50	None
NORTREL 28 DAY KitNorethindrone And Ethinyl Estradiol	2Generic	$5.00	$12.50	None
NORTREL 7/7/7 (28 DAY REGIMEN) KitNorethindrone And Ethinyl Estradiol	2Generic	$5.00	$12.50	None
NORTRIPTYLINE HYDROCHLORIDE 10 mg Capsule	2Generic	$5.00	$12.50	None
NORTRIPTYLINE HYDROCHLORIDE 10 mg/5mL Solution	2Generic	$5.00	$12.50	None
NORTRIPTYLINE HYDROCHLORIDE 25 mg Capsule	2Generic	$5.00	$12.50	None
NORTRIPTYLINE HYDROCHLORIDE 50 mg Capsule	2Generic	$5.00	$12.50	None
NORTRIPTYLINE HYDROCHLORIDE 75 mg Capsule	2Generic	$5.00	$12.50	None
NORVIR 100 mg PowderRitonavir	4Non-Preferred Drug	25%	25%	None
NOURIANZ 20 mg Tablet, Film CoatedIstradefylline	5Specialty Tier	25%	N/A	PA QL 31 per 31 days
NOURIANZ 40 mg Tablet, Film CoatedIstradefylline	5Specialty Tier	25%	N/A	PA QL 31 per 31 days
NOVOLIN 70/30 100 [iU]/mL Injection, SuspensionHuman Insulin	3Preferred Brand	25%	25%	None
NOVOLIN 70/30 100 [iU]/mL Injection, SuspensionHuman Insulin	3Preferred Brand	25%	25%	None
NOVOLIN N 100 [iU]/mL Injection, SuspensionHuman Insulin	3Preferred Brand	25%	25%	None
NOVOLIN N 100 [iU]/mL Injection, SuspensionHuman Insulin	3Preferred Brand	25%	25%	None
NOVOLIN R 100 [iU]/mL Injection, SolutionHuman Insulin	3Preferred Brand	25%	25%	None
NOVOLIN R 100 [iU]/mL Injection, SolutionHuman Insulin	3Preferred Brand	25%	25%	None
NOVOLOG 100 [iU]/mL Injection, SolutionInsulin Aspart	3Preferred Brand	25%	25%	None
NOVOLOG 100 [iU]/mL Injection, SolutionInsulin Aspart	3Preferred Brand	25%	25%	None
NOVOLOG 100 [iU]/mL Injection, SolutionInsulin Aspart	3Preferred Brand	25%	25%	None
NOVOLOG MIX 70/30 100 [iU]/mL Injection, SuspensionInsulin Aspart	3Preferred Brand	25%	25%	None
NOVOLOG MIX 70/30 100 [iU]/mL Injection, SuspensionInsulin Aspart	3Preferred Brand	25%	25%	None
NUBEQA 300 mg Tablet, Film CoatedDarolutamide	5Specialty Tier	25%	N/A	PA QL 124 per 31 days
NUCYNTA 100 mg Tablet, Film CoatedTapentadol Hydrochloride	5Specialty Tier	25%	N/A	PA QL 186 per 31 days
NUCYNTA 50 mg Tablet, Film CoatedTapentadol Hydrochloride	4Non-Preferred Drug	25%	25%	PA QL 186 per 31 days
NUCYNTA 75 mg Tablet, Film CoatedTapentadol Hydrochloride	5Specialty Tier	25%	N/A	PA QL 186 per 31 days
NUEDEXTA 20/10 mg Capsule, Gelatin CoatedDextromethorphan Hydrobromide And Quinidine Sulfate	5Specialty Tier	25%	N/A	PA QL 62 per 31 days
NUPLAZID 10 mg Tablet, CoatedPimavanserin Tartrate	5Specialty Tier	25%	N/A	PA QL 31 per 31 days
NUPLAZID 34 mg CapsulePimavanserin Tartrate	5Specialty Tier	25%	N/A	PA QL 31 per 31 days
NURTEC ODT 75 mg Tablet, Orally DisintegratingRimegepant Sulfate	5Specialty Tier	25%	N/A	PA QL 18 per 28 days
NUZYRA 100 mg/5mL Injection, Powder, Lyophilized, For SolutionOmadacycline	5Specialty Tier	25%	N/A	None
NUZYRA 150 mg Tablet, Film CoatedOmadacycline	5Specialty Tier	25%	N/A	None
NYAMYC 100000 [USP'U]/g PowderNystatin	2Generic	$5.00	$12.50	QL 6 per 28 days
NYLIA 1/35 KitNorethindrone And Ethinyl Estradiol	2Generic	$5.00	$12.50	None
NYLIA 7/7/7 KitNorethindrone And Ethinyl Estradiol	2Generic	$5.00	$12.50	None
NYSTATIN 100000 [USP'U]/g Cream	2Generic	$5.00	$12.50	QL 3 per 28 days
NYSTATIN 100000 [USP'U]/g Ointment	2Generic	$5.00	$12.50	QL 3 per 28 days
NYSTATIN 100000 [USP'U]/g Powder	2Generic	$5.00	$12.50	QL 6 per 28 days
NYSTATIN 100000 [USP'U]/mL Suspension	2Generic	$5.00	$12.50	None
NYSTATIN 500000 [USP'U] Tablet, Coated	2Generic	$5.00	$12.50	None
NYSTATIN AND TRIAMCINOLONE ACETONIDE 100000/1 [USP'U]/g/mg/g CreamNystatin, Triamcinolone Acetonide	3Preferred Brand	25%	25%	QL 6 per 28 days
NYSTATIN AND TRIAMCINOLONE ACETONIDE 100000/1 [USP'U]/g/mg/g Ointment	3Preferred Brand	25%	25%	QL 6 per 28 days
NYSTOP 100000 [USP'U]/g PowderNystatin	2Generic	$5.00	$12.50	QL 6 per 28 days

PA = prior authorization, ST = step therapy, QL = quantity limit. Costs are the plan’s initial-coverage cost-sharing from the CMS 2026 formulary files; a drug not listed here is not on this plan’s formulary, though a formulary exception may still be possible.